| NPI | 1902992308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0054626) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ME MD15542) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: CO DR.0054626) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2015-01-15 |